| NPI | 1124338066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 019300) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 002440) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2016-02-11 |